ATI Pharm 1
A nurse in a provider's office is collecting data from a client who has been taking black cohosh. Which of the following statements by the client indicates a therapeutic effect from the supplement?
"I am having fewer hot flashes now that I am taking black cohosh." Black cohosh is used for treating symptoms of menopause such as hot flashes, vaginal dryness, irritability, and night sweats.
Cholesterol meds
-statin (Atorvastatin, Simvastatin, Lovastatin) Report sore muscles & cramps. AR: Liver toxicity (ALT & AST), avoid grapefruit (except Pravastatin) & St John's Wart, take at night. Bad: Cholesterol >200, triglycerides >150, LDL >100, HDL<40
diphenhydramine hydrochloride
An H-2 blocker antihistamine used to relieve symptoms of allergy, hay fever, and the common cold. X: narrow-angle glaucoma
Calcium Channel Blockers
Calcium channel blockers (amlodipine, felodipine, nifedipine, verapamil.) lower blood pressure. They work by preventing calcium from entering the cells of the heart and arteries
nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications?
Naproxen The nurse should anticipate that the provider will prescribe an NSAID such as naproxen. This type of medication is recommended as the first choice of treatment for relieving the manifestations of an acute gout attack.
A nurse is collecting data from a client who is receiving clozapine to treat schizophrenia. The nurse should identify that an increase in which of the following parameters is an early indication of agranulocytosis?
Temperature Antipsychotic medications such as clozapine can cause agranulocytosis, which is the depletion of WBCs. This increases the client's risk of infection. A fever is an early indication that the client should have a WBC count check to detect agranulocytosis. AR: urinary retention, orthostatic hypotension.
A nurse is caring for a client who has COPD and has been taking fluticasone via inhaler for many years. Which of the following findings should the nurse identify as an adverse effect of long-term use of this medication?
The nurse should identify adrenal insufficiency as an adverse effect of the long-term use of an inhaled corticosteroid such as fluticasone. Manifestations can include anorexia, weakness, nausea, hypotension, and hypoglycemia. Long-term use of inhaled corticosteroids does not cause liver damage or disease.
A nurse is reviewing the medical record of a client who has postmenopausal osteoporosis and a prescription for raloxifene. Which of the following findings in the client's medical record should the nurse identify as a contraindication to receiving this medication?
The nurse should identify that a history of DVT is a contraindication for receiving raloxifene because this medication can cause DVT in clients who have a prior history. Therefore, the nurse should notify the provider of this finding and request an alternative medication prescription for the client.
Comorbidity
medical conditions that co-exist in a client
nurse in a provider's office is reinforcing teaching with a female client who has a new diagnosis of seizures and a prescription for valproic acid. Which of the following pieces of information should the nurse provide?
"This medication can cause changes in your mood and behavior." All anti-seizure medications can cause an increased risk of suicidal thoughts and behavior. The nurse should inform the client of this adverse effect and instruct her to notify the provider if depression, anxiety, panic, or thoughts of dying occur.
ACE Inhiitors
-pril, blood pressure
A nurse manager is instructing a newly licensed nurse about routes of medication administration. Which of the following routes involves medication absorption through the mucous membranes under the tongue?
Absorption through the sublingual route occurs by placing the medication under the tongue.
A nurse is caring for a client who has a prescription for subdermal etonogestrel. The nurse should alert the provider about which of the following findings in the client's medical history?
Birth control hormone in a plastic rod. St. John's wort can reduce the effects of subdermal etonogestrel because it stimulates hepatic drug-metabolizing enzymes. Therefore, the nurse should alert the provider about the client's use of St. John's wort, and it should be discontinued.
Budesonide
Budesonide is an inhaled corticosteroid prescribed to decrease inflammation in clients who have asthma. This medication is for those with more severe forms of asthma to prevent an asthma attack.
A nurse is caring for a client who has a vitamin K deficiency. Which of the following manifestations should the nurse expect?
Excessive bruising Vitamin K is needed by clotting factors to coagulate the blood. Therefore, a client who has a deficiency in vitamin K is at risk for excessive bruising and bleeding.
Alendronate Sodium
Osteoporosis Agent, Piaget's disease (X: esophageal stricture)
omeprazole
PPI that treats heartburn, gastric ulcers, erosive esophagitis and GERD. Causes bone loss. Brandname: Prilosec.
Amiodarone
antiarrhythmic that treats and prevent ventricular arrhythmias
Anticoagulant drugs
aspirin, heparin, warfarin, dabigatran
A nurse is reinforcing teaching with a client who has a new diagnosis of peptic ulcer disease (PUD) and a prescription for bismuth subsalicylate. The client asks the nurse, "How will this medication help my ulcer?" Which of the following statements should the nurse make?
bismuth subsalicylate treat diarrhea, heartburn, and upset stomach and can assist by eliminating the bacteria Helicobacter pylori, which can cause PUD.
Inotropic agents IV
epinephrine, norepinephrine, dopamine, digoxin
Colonoscopy recommendations
every 5 - 10 years beginning 50 years old
magnesium level
expected reference range of 1.3 to 2.1 mg/dL - monitor the client's magnesium risk for a decreased state of alertness due to dizziness
WBC count
expected reference range of 5,000 to 10,000/mm
Digoxin
need to maintain a potassium level between 3.5 to 5.0 mg/dL to avoid digoxin toxicity. A. Visual disturbances such as blurred vision or yellow vision can occur with digoxin toxicity. Report a heart rate of <60/min, which can signify digoxin toxicity.
A nurse is reinforcing teaching with a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this medication?
"Carry a supply of pills and a single-use injectable preparation with you at all times." The nurse should tell the client to carry an emergency supply of the medication to take during times of unexpected stress. The client should carry an adequate supply at all times, which should include an injectable preparation plus a supply equal to the regular oral dosage. The single-use injectable preparation should be administered IM if the client has an emergency and needs an extra dose of the glucocorticoid.
A nurse is monitoring a client who received diphenoxylate-atropine. Which of the following statements by the client should indicate to the nurse that the medication has been effective?
"I have not had a bowel movement today." The nurse should identify that diphenoxylate-atropine is an opioid used to treat diarrhea. The therapeutic response of this medication is a decrease in the frequency of watery stools due to reduced motility of the intestinal lining. AR: drowsiness, dry mouth,
A nurse is caring for a client who has tuberculosis and is taking rifampin. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of the medication?
"I have noticed my urine is orange in color." The nurse should identify that an adverse effect of rifampin can be red-orange colored urine, saliva, sweat, and tears as the medication is excreted from the body. The nurse should also inform the client that permanent staining of contact lenses can occur. However, this adverse effect is harmless. The client should inform the provider if urine becomes dark in color since this can be an indication of hepatotoxicity.
A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicates an understanding of the teaching?
"I should change positions slowly when getting out of bed." The nurse should identify that isosorbide mononitrate is an antianginal medication that produces vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should change positions slowly upon rising to minimize the effects of orthostatic hypotension.
A nurse in a provider's office is reinforcing teaching with a client who has an elevated prostate-specific antigen level and a new prescription for finasteride. Which of the following statements by the client indicates an understanding of the teaching?
"I will skip donating blood while I am taking this medication." The nurse should reinforce with the client that finasteride is teratogenic to male fetuses and carries an FDA Pregnancy Risk Category X. Pregnant women should not handle the medication, and men who are taking it should not donate blood until it has been discontinued for at least 1 month.
A nurse is reinforcing teaching with a client who has a prescription for chenodiol for the treatment of gallstones. Which of the following client statements indicates an understanding of the teaching?
"Liver function tests are required while taking this medication." The nurse should identify that chenodiol is hepatotoxic and can injure the liver. Periodic liver function tests are required during treatment. This medication is contraindicated in clients who have a preexisting liver condition. Treatment with chenodiol usually lasts for 2 years. Chenodiol can cause dose-dependent diarrhea. Pregnancy risk.
A nurse is reinforcing teaching with a client who is postmenopausal and has a prescription for alendronate. Which of the following statements should the nurse include in the teaching?
"Take this medication on an empty stomach." Alendronate is osteoporosis med. The nurse should instruct the client to avoid taking alendronate with food or liquids other than water because it can decrease absorption. The client should only take this medication with water 30 minutes before breakfast. remain in a sitting or upright position for 30 minutes after taking this medication to prevent esophagitis from occurring and take with a full glass of water. Do not take with antacids high in metal or calcium that can interfere with absorption.
A nurse is reinforcing teaching with a client who has a prescription for famotidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching?
"This medication is less effective for people who smoke." The nurse should reinforce with the client that smoking interferes with the effectiveness of famotidine. food does not affect the absorption of famotidine. take antacids at least 30 to 60 min after taking famotidine. AR: dizziness
nurse is reinforcing teaching with a client who has been taking an NSAID to treat rheumatoid arthritis. During the client's first month checkup, the provider prescribed methotrexate to be added to the medication regimen. Which of the following statements should the nurse include in the teaching about the purpose of this change in the client's medication?
"This medication was added to delay the disease progression." The nurse should inform the client that the provider prescribed methotrexate to be added to the medication regimen along with an NSAID to delay the progression of the disease and to delay joint damage or deformity that can result from the disease. Methotrexate does not have to reach a therapeutic range in the client's blood to be effective. However, it is the fastest acting medication in its class and has a therapeutic effect at 3 to 6 weeks.
A nurse is reinforcing teaching with a client who has tuberculosis and a prescription for isoniazid. Which of the following instructions should the nurse include?
"Your provider will monitor your liver function while you are taking this medication." The provider will monitor the client's liver function while taking isoniazid due to the risk of hepatotoxicity. The therapy usually lasts 6 to 9 months. Take isoniazid on an empty stomach to increase absorption.
ARBs (Angiotensin II Receptor Blockers)
-sartan (losartan, valsartan) Vasodilator. Check apical pulse and BP.
A nurse is caring for a client who has been receiving gastrostomy tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subcutaneously?
6:45 - lispro onset is 15 min.
Hodgkin's lymphoma
A cancer of lymph nodes, spleen, liver and bone marrow. S&S: enlarged painless lymph node, or nodes, night sweats, unexplained weight loss, a fever, and pruritus.
A nurse is reinforcing teaching with a client who has allergic rhinitis about a new prescription for brompheniramine. Which of the following pieces of information should the nurse include in the teaching?
A client who takes a first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Taking frequent sips of liquid or sucking on a hard, sugarless candy can help relieve dry mouth.
Aminophylline & Fluticasone
Aminophylline is a systemic methylxanthine that helps decrease smooth muscle contraction, dilating the bronchioles. Fluticasone is an inhaled corticosteroid that decreases airway inflammation. These medications can be administered concurrently without causing additional harm to the client.
NSAIDs
Anti-inflammatory & antipyretic. Effective for gout and RA. *Asthma patient use acetaminophen. Naproxen, Salicylate acid (Aspirin), Acetylsalicylic acid (Aspirin, anticoagulant), ibuprofen & Indomethacin, Ketorolac (brand: Toradol via IV), celecoxib. AR: kidney damage (creatinine over 1.3), GI bleeding risk, clots, CHF & HTN and asthma worsen. Do not take on an empty stomach but can take with PPI.
A nurse is preparing to administer nitroglycerin topical ointment to a client who has angina. Which of the following actions should the nurse take?
Apply the ointment using a dose-measuring applicator The nurse should apply the ointment using a dose-measuring applicator. This allows the nurse to measure the correct dose the client is to receive.
A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider?
Aspirin EC 325 mg per NG tube daily The nurse should clarify the prescription for aspirin EC 325 mg per NG tube daily, as enteric-coated tablets should not be crushed.
Atropine
Atropine Sulfate Injection is an antimuscarinic agent used to treat bradycardia (low heart rate), reduce salivation and bronchial secretions before surgery. Ophthalmic atropine is used before eye examinations to dilate (open) the pupil. Atropine block PNS and turns on the SNS.
A nurse is reinforcing teaching with an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the instructions?
Chicken salad Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged such as lunchmeats and cheeses. This menu selection does not contain foods high in tyramine; therefore, it is the best choice.
A nurse is reviewing the medical record of a client who might have hearing loss. Which of the following pieces of information from the client's medical record should the nurse identify as a risk factor for hearing loss?
Chronic use of salicylates such as aspirin can lead to ototoxicity, which can manifest as tinnitus or hearing loss.
A nurse is reviewing the laboratory results of a client who is taking tobramycin and notes that the medication's peak level is 7 mcg/mL. Which of the following actions should the nurse take?
Continue to administer the medication as prescribed The nurse should identify that a peak level of 7 mcg/mL for a tobramycin is within the expected reference range of 5 to 10 mcg/mL. Therefore, the nurse should continue to administer the scheduled medication as prescribed.
A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client states, "I forget what the other nurse told me this medication does." Which of the following pieces of information should the nurse reinforce with the client?
Correct Answer: C. "It can reduce your risk of having a stroke." The nurse should identify that atrial fibrillation increases the client's risk of having a stroke due to clot formation in the atrium. Warfarin can prevent clot formation when used long-term, which will reduce the client's risk of having a stroke. Incorrect Answers:A. The nurse should identify that conversion of rhythms is not an indication of warfarin because warfarin is anticoagulant. Other medications such as amiodarone can assist with conversion of arrhythmias to a normal sinus rhythm. B. The nurse should identify that thrombolytic medications dissolve clots. Warfarin is an anticoagulant and cannot dissolve clots. D. The nurse should identify that hemorrhage is an adverse effect of warfarin.
ACE Inhibitors
First line therapy for HTN. -pril (captopril, enalapril, lisinopril) Reduce after load. Check apical pulse and BP. Give 1 hour before meal. May cause hyperkalemia. Avoid salt substitutes. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are less effective in clients who are African-American than in clients who are white. Adverse effects include a persistent cough, angioedema, and hyperkalemia. ACE inhibitors are contraindicated in pregnancy.
Furosemide
Furosemide is a loop diuretic and treats conditions with volume overload and edema secondary to congestive heart failure exacerbation, liver failure, or renal failure, including the nephrotic syndrome. Furosemide can cause ototoxicity, tinnitus and difficulty hearing, especially in older adult clients, due to a decrease in medication metabolism in the kidneys.
A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication?
Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication. Di pt lacks ADH and pees a lot.
A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication?
Heart rate 51/min The nurse should identify that if the client's heart rate is less than 60/min, the medication should be withheld, and the provider should be notified.
A nurse is collecting data on a client who has developed hypertension that is unresponsive to lifestyle changes. The client has no other comorbidities. Which of the following medications should the nurse expect the provider to prescribe first?
Hydrochlorothiazide is a thiazide diuretic that is used alone or with other antihypertensive agents. It is a first-line choice for treating hypertension. Hydrochlorothiazide is the most frequently prescribed medication for hypertension.
A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?
Hypotension Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage.
Ipratopium & tiotropium
Ipratopium is a form of atropine that is prescribed to treat bronchospasms related to COPD. It is not an approved medication to treat clients who have asthma. Tiotropium is a long-acting inhaled anticholinergic that is prescribed for long-term maintenance therapy for clients who have COPD.
A nurse is monitoring a client with pneumonia who has received penicillin G intramuscularly (IM). Which of the following findings should the nurse plan to evaluate first?
Laryngeal edema Laryngeal edema can indicate the client is experiencing an allergic/anaphylactic reaction to penicillin G, and requires epinephrine in addition to respiratory support.
A nurse is preparing to administer an initial dose of zileuton to a client for asthma prophylaxis. For which of the following manifestations should the nurse monitor as a potential adverse reaction?
Leukotriene modifiers such as zileuton can cause adverse neuropsychiatric effects like hallucinations, unusual dreams, agitation, anxiety, and suicidal thinking. The nurse should report this adverse effect so the provider can consider switching the client to a different medication.
A nurse is reviewing the medication administration record of a client who has impaired swallowing. The nurse should crush the medication when administering which of the following prescriptio
Levothyroxine 75 mcg PO q AM before breakfast Levothyroxine can be crushed because it is not extended-release, sublingual, or enteric-coated. If crushed, the medication should be mixed with 5 to 10 mL of water.
A nurse is reinforcing teaching with a client about taking tetracycline PO. Which of the following statements should the nurse include in the teaching?
Limit your consumption of dairy products while taking this medicine." The nurse should tell the client to avoid or limit the consumption of dairy products while taking tetracycline. An interval of at least 2 hours should separate tetracycline ingestion and the ingestion of products that can chelate this medication such as milk or calcium.
A nurse is collecting data from a client who has tuberculosis and a prescription for ethambutol. The nurse should inform the client that he is likely to develop which of the following alterations as an adverse effect of this medication?
Loss of red/green color discrimination Ethambutol is an antitubercular medication that impairs ribonucleic acid synthesis. A common adverse reaction is the loss of red/green color discrimination due to optic neuritis. The nurse should notify the provider of this finding and expect a prescription to discontinue the medication.
A nurse is reinforcing teaching with a newly licensed nurse about metoclopramide. The nurse should include in the teaching that which of the following conditions is a contraindication to this medication?
Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.
A nurse is caring for a client who has developed a mild Clostridium difficile infection following antibiotic therapy. After discontinuing the current antibiotic, the nurse should expect the provider to prescribe which of the following medications?
Metronidazole is a nitroimidazole antibiotic that is active against anaerobic bacteria such as C. difficile infection. It is the drug of choice for mild to moderate cases of C. difficile. Metronidazole is also effective against protozoal infections.
A nurse is caring for a client who was recently diagnosed with Addison's disease and placed on long-term mineralocorticoid therapy with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy?
Mineralocorticoids, specifically aldosterone, are necessary for the regulation of fluid and electrolyte balance, particularly of sodium, potassium, and water. Addison's disease results in a deficiency of cortisol and aldosterone production and requires supplementation with glucocorticoids and mineralocorticoids. Fludrocortisone is the only mineralocorticoid available.
Aspirin patient teaching
NSAID. Fever & pain reducer, antiflammatory, blood thinner. Toxicity - tinnitus (earliest sign), tachycardia, hypertension Avoid kids (Reye's syndrome, use ibuprophen and acetaminophen). Anything with salicylate meds are bad for kids incl. Bismuth subsalicylate (Pepto-Bismol)
NSAIDs side effects & precautions
NSAIDS: Do not take if: GI bleed, ulcers, asthma & nasal polyps (use acetaminophen instead), HTN and Heart failure, kidney (renal disfunction)- increased creatinine (over 1.3) & BUN, urine output less than 30ml, blood clots. -Never take 2 NSAIDs simultaneously. use lowest dose, shortest time. -Increased risk for thrombosis, blood clots -Increased bleed risk: bruising, tarry stool, coffee ground emesis -Take with food, never on empty stomach -Avoid EGGO vitamins (vitamin E, Gingko, garlic and Omega 3 oil) for increased bleed risk - no orthostatic hypotension, no sedation, no suicidal risk
A nurse is preparing an in-service session for medical-surgical staff on infections and antibiotic use. Which of the following antibiotics should the nurse identify as having the highest rate of severe allergic reactions?
Penicillins carry the highest rate of severe allergic reactions. If a client is allergic to a penicillin, he or she should be considered allergic to all of them. A client who is identified as having a severe allergic reaction to penicillins should not receive them again unless there is no other medication available to treat a life-threatening infection. Penicillins are broad-spectrum antibiotics used to treat most gram-positive and some gram-negative infections.
A nurse is reinforcing teaching with a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following pieces of information should the nurse include in the teaching?
Pravastatin can be taken with grapefruit juice. Pravastatin, unlike other statins, such as lovastatin, simvastatin, and atorvastatin, is not affected by CYP3A4 inhibitors. It is safe for the client to consume grapefruit juice if desired.
Beta blockers
Propranolol, metoprolol, carvedilol, timolol. Decrease HR and dilate blood vessels - HTN, HF, arrhythmia, glaucoma, angina, prevent MI. Reduce SNS input and improve cardiac output. Check apical pulse for 1 min prior and 30 min after. If below 60 bpm or systolic BP below 100 mm Hg, report HCP. Rise slowly. Contraindications: bradycardia, HF, asthma, emphysema. Do not take with: antidepressants, NSAID, diuretics, lodocaine. Metoprolol is a beta-adrenergic blocker that is widely used for hypertension. Like ACE inhibitors, beta blockers are less effective in clients who are African-American than in clients who are white. Beta blockers cannot be prescribed to clients who have heart blocks and should be used with caution in clients who have heart failure since they can lead to bradycardia.
A nurse is caring for a client who is at 6 weeks of gestation and has just received a diagnosis of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following medications?
Propylthiouracil This medication is used to treat hyperthyroidism during the first trimester of pregnancy because it does not cross the placental barrier well, posing little risk to the fetus. However, methimazole is the preferred medication in the second and third trimesters of pregnancy.
A nurse is caring for a client who has rheumatoid arthritis and a new prescription for etanercept. Which of the following values should the nurse review prior to the administration of the medication?
Results of last purified protein derivative (PPD) test The nurse should identify that a client who is taking etanercept is at risk for infections such as tuberculosis (TB). To reduce this risk, the client should be tested for latent TB; if the test is positive, the client should undergo TB treatment before receiving etanercept. During treatment with etanercept, the client should be monitored closely for the development of TB.
Salmeterol & levalbuterol
Salmeterol is a long-acting beta2-agonist bronchodilator, and levalbuterol is a short-acting beta2-agonist bronchodilator. These medications are often prescribed together for both short- and long-term control of asthma manifestations.
A nurse is caring for a client who is taking selegiline. The nurse should monitor the client for which of the following findings as an adverse effect of selegiline and notify the provider?
Selegiline is MAO inhibitor and helps control the symptoms of Parkinson's Disease. Drowsiness can be an adverse effect of selegiline, which can also be a manifestation of serotonin syndrome. The nurse should notify the provider of this finding immediately.
Breast assessment recommendations
Self examination - start early 20's Breast exam by doctor every 3 years from 20-39 years Mammograms annually from age 40
Serotonin Syndrome
Serotonin Syndrome may begin within minutes to hours after initiation of any medication that increases serotonin levels. Mild clinical features include restlessness, drowsiness, diaphoresis, tachycardia, hypertension, and diarrhea. Moderate effects include hyperthermia, decreased level of consciousness, and muscle rigidity.
A nurse is reinforcing teaching with a client who has dyspepsia about prescribed antacids. Which of the following statements should the nurse include in the teaching?
Take antacids 1 hour apart from other medications." The nurse should include in the teaching that antacids increase gastric pH, which causes an interference with the absorption of various medications. To help minimize these interactions, the client should take the antacids at least 1 hour apart from other medications.
A nurse is reinforcing teaching with a client who is taking levothyroxine to treat hypothyroidism and has a new prescription for a calcium supplement. Which of the following pieces of information should the nurse include in the teaching?
Take the calcium supplement 4 hours apart from taking the levothyroxine. Levothyroxine should be taken first thing in the morning on an empty stomach, and the calcium supplement should be taken at least 4 hours later. Food or supplements containing iron, magnesium, or zinc also bind to levothyroxine and prevent complete absorption of the medication.
A nurse is caring for a client who has multiple sclerosis and is receiving interferon beta-1a. The nurse should identify that which of the following client statements indicates a potential adverse effect of the medication?
The adverse effects of interferon beta-1a can include flu-like symptoms such as general body and muscle aches.
A nurse is reinforcing teaching with a client who has diabetes mellitus about a new prescription for pioglitazone. Which of the following statements should the nurse include in the teaching?
The client can take pioglitazone when using insulin because pioglitazone increases the cellular response to insulin, and insulin is needed in order for the medication to be effective.
A nurse is reinforcing teaching with the guardian of an infant about the diphtheria, tetanus, and pertussis (DTaP) vaccine. Which of the following pieces of information should the nurse include in the teaching?
The first immunization for DTaP in the series is given at 2 months." The nurse should tell the guardian that the first immunization of DTaP is given at 2 months, with the rest of the vaccinations occurring at 4 months, 6 months, 15 to 18 months, and 4 to 6 years of age.
A nurse is collecting data from a client who is receiving omeprazole to treat a gastric ulcer. Which of the following findings should the nurse report to the provider immediately?
The greatest risk to this client is an increased risk of developing Clostridium difficile, hypomagnesemia and pneumonia.
A nurse is caring for a client who is taking acarbose to treat type 2 diabetes mellitus. For which of the following adverse effects of this medication should the nurse monitor?
The most common adverse effects of acarbose, an alpha-glucosidase inhibitor, are gastrointestinal. They include diarrhea, abdominal distention and cramping, and flatulence.
A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client?
The nurse should anticipate a client who has mild intermittent asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short-acting beta2-agonist that activates beta2-receptors in the smooth muscle of the lung, allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.
A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications for daily management of this condition?
The nurse should anticipate that the provider will prescribe celecoxib, which is a nonsteroidal anti-inflammatory drug (NSAID). This medication or another NSAID should be initiated for a client who has a new diagnosis of rheumatoid arthritis.
A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). Which of the following prescriptions should the nurse expect?
The nurse should expect a prescription for finasteride for a client who has BPH. Finasteride is a 5-alpha-reductase inhibitor that is administered to reduce the size of the prostate within 3 to 6 months of therapy.
A nurse is collecting data from a client who is taking theophylline. The client's dose was decreased due to concurrent use with cimetidine. Which of the following findings should the nurse expect?
The nurse should identify that a theophylline level of 15 mcg/mL is within the expected reference range of 10 to 20 mcg/mL and indicates the dose is appropriate for this client.
A nurse is collecting data from a client with rheumatoid arthritis who has been taking high doses of prescribed hydroxychloroquine. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of hydroxychloroquine?
The nurse should identify that hydroxychloroquine is an antimalarial medication used to treat rheumatoid arthritis. Clients who take hydroxychloroquine in high doses are at risk for developing retinopathy, which can be irreversible and cause blindness.
A nurse is reviewing a new prescription for fexofenadine for a 7-year-old client who has seasonal allergies. Which of the following findings should the nurse clarify with the provider?
The nurse should identify that this 7-year-old client has been prescribed a standard tablet, which is appropriate for clients 12 years of age and older. Therefore, the nurse should clarify this aspect of the prescription with the provider because a client who is 7 years old should be administered orally disintegrating tablets or a suspensio
A nurse is caring for a client who has severe asthma and allergic rhinitis. The client is taking theophylline. Which of the following medications should the nurse identify as being incompatible with theophylline?
The nurse should identify that zafirlukast is a leukotriene receptor antagonist prescribed for asthma maintenance. Concurrent use of zafirlukast along with theophylline suppresses the metabolism of theophylline, which can lead to toxicity. Therefore, another medication should be used.
A nurse is reinforcing teaching with a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching?
The nurse should instruct the client to activate the pump initially by holding the bottle upright and depressing the 2 white side arms toward the bottle 6 times. The nurse should instruct the client to administer calcitonin-salmon to a nostril daily, alternating nostrils. Calcitonin-salmon is a long-term treatment therapy for postmenopausal osteoporosis.
A nurse is reinforcing teaching about how to take donepezil with a client who was recently diagnosed with early Alzheimer's disease. Which of the following instructions should the nurse include?
The nurse should instruct the client to take donepezil late in the evening, just before going to bed.
A nurse is reinforcing discharge teaching with a client who has a new prescription for amlodipine. For which of the following findings should the client notify the provider?
The nurse should reinforce with the client that amlodipine can cause bradycardia. The nurse should instruct the client about the correct technique for obtaining a pulse and advise notifying the provider if the heart rate drops below 50/min.
A nurse is reinforcing teaching with a client who has osteoporosis about a new prescription for risedronate. Which of the following client statements indicates an understanding of the teaching?
The nurse should reinforce with the client that risedronate should be taken with at least 180 to 240 mL (6 to 8 oz) of water. remain upright for at least 30 minutes after taking, take on empty stomach in the morning, at least 30 min before meal.
A nurse is reinforcing teaching about preventing systemic toxicity with a client who is using topical lidocaine. Which of the following pieces of information should the nurse include about the application of topical lidocaine?
The nurse should tell the client to apply topical lidocaine to skin that is intact rather than blistered, broken, or irritated to prevent a large amount of medication from being absorbed and to decrease the risk of systemic toxicity.
A nurse is reviewing the medication history of a client who has asthma. Which of the following medication combinations should the nurse identify as incompatible?
Theophylline and zileuton The nurse should identify that zileuton, a leukotriene modifier, impairs the metabolism of certain medications. Concurrent use of zileuton with theophylline can cause toxicity due to elevated theophylline, which is a systemic methylxanthine used to relax the smooth muscles of the airway. Therefore, these medications are incompatible when used together. Albuterol is a short-acting beta2-agonist bronchodilator, and montelukast is a leukotriene modifier. These medications are often prescribed together to treat the immediate manifestations of asthma as well as to help prevent asthma attack.
A nurse is collecting data from a client who has hypothyroidism and takes levothyroxine. Which of the following findings indicates that the client is experiencing acute levothyroxine overdose?
Tremor and anxiety are expected findings in acute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism. Expected findings: tachycardia, heat intolerance, hyperthermia.
A nurse in an outpatient facility is collecting data from a client who has a prescription for furosemide 40 mg daily. The client reports that she has been taking extra doses to promote weight loss. Which of the following findings indicates that the client is dehydrated?
Urine specific gravity 1.035 Oliguria (increased urine concentration) and an increase in urine specific gravity >1.030 are expected findings in clients who are dehydrated.
Vancomycin
Vancomycin is a glycopeptide antibiotic that is active against serious infections such as MRSA, staphylococcus epidermidis, streptococci, and penicillin-resistant pneumococci. It is the drug of choice for severe cases of C. difficile infection. Vancomycin works only against gram-positive bacteria and should be reserved for treatment against severe infections.
A nurse is collecting data from a client who has been taking simvastatin to treat hyperlipidemia. Which of the following statements by the client indicates an adverse effect of the medication that should be reported to the provider immediately?
When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is muscle pain and weakness. A serious adverse effect of this medication is muscle injury, which can progress to severe myositis. The client should report any unusual onset of muscle pain or tenderness to the provider immediately.
A nurse is administering a medication to a client. The nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes?
medication being lipid soluble and the presence of a transport system both facilitate the ability of a medication to cross cell membranes that separate the medication from the blood.
A nurse is caring for a female client who has been taking clomiphene to treat infertility. Which of the following findings should indicate to the nurse that the medication has been effective?
nurse should identify that clomiphene is a medication that promotes follicular maturation and is used in the treatment of infertility. Successful treatment reveals progressive follicular enlargement, followed by conversion of the follicle to a corpus luteum after ovulation occ
